Report: CMS Not Issuing New Medicare ID Cards to Identity Theft Victims

Nearly 284,000 Medicare beneficiaries who have been victims of identity theft are facing difficulties accessing health care services because the federal government has not given them replacement ID cards, according to a report released Wednesday by the HHS Office of Inspector General, USA Today reports.

Medicare officials cited cost and the required involvement of multiple agencies as reasons for not replacing the cards, HHS OIG investigators said. According to USA Today, Medicare ID numbers are directly linked to beneficiaries' Social Security numbers, which the government cannot reissue for the identity theft victims.

Beneficiaries can only report misuse of their Medicare IDs, and the government does not provide updates about the ID theft investigation or amend victims' records with accurate billing information, factors that prevent patients from easily accessing care, the report says.

Report's Recommendations

The report says that CMS "should mitigate the damage of medical identity theft by ensuring that beneficiaries retain their access to services if their Medicare numbers have been misused by others." The report also recommends that:

CMS assign an indicator to breached records or records that have been used fraudulently so that claims processors can determine when a legitimate claim should go through;

The government devise a way to issue new numbers, even if it might require a shift away from using beneficiaries' Social Security numbers; and

CMS correct beneficiaries' billing records when fraudulent activity has occurred (Kennedy, USA Today, 10/10).

At a House hearing in August that looked at the use of Social Security numbers on Medicare cards, Medicare Chief Information Officer Tony Trenkle said the agency would need six more months to estimate the cost of removing the numbers from the cards. CMS could not provide a timetable for the new cards without having an accurate cost estimate, Trenkle added (California Healthline, 8/2).

CMS Responds to OIG Report

CMS officials said they would consider the suggestion to place an indicator on breached or fraudulently used records, but they disagreed with the recommendation to correct the billing records.

In response to the report, acting CMS Administrator Marilyn Tavenner said, "Our major concern is that CMS's adjustment of beneficiary billing records could have a negative impact on criminal and civil prosecutions and on the underlying integrity of the Medicare claims processing system" (USA Today, 10/10).